Effective Date: October 13, 2025
This Notice describes how medical information about you may be used and disclosed and how you can get access to this information.

Our Legal Duty

We are required by HIPAA (45 CFR Parts 160 and 164) and New York State law (Public
Health Law §§ 17 & 18, N.Y. Comp. Codes R. & Regs. Title 10 Part 50, NYS Civil Rights Law § 79-l) to:

• Maintain the privacy of your Protected Health Information (PHI).
• Provide you with this Notice.
• Follow the terms of this Notice.

Permitted Uses and Disclosures Without Written Authorization

Under 45 CFR §164.502(a) and §164.512, and NYS law, we may use or disclose your PHI
without written authorization for:

1. Treatment – 45 CFR §164.506
2. Payment – 45 CFR §164.506
3. Healthcare Operations – 45 CFR §164.506
4. Required by Law – 45 CFR §164.512(a)
5. Public Health Activities – 45 CFR §164.512(b)
6. Health Oversight Activities – 45 CFR §164.512(d)
7. Judicial and Administrative Proceedings – 45 CFR §164.512(e)
8. Law Enforcement Purposes – 45 CFR §164.512(f)
9.  Coroners, Medical Examiners, and Funeral Directors – 45 CFR §164.512(g)
10. Organ, Eye, or Tissue Donation – 45 CFR §164.512(h)
11. Research – 45 CFR §164.512(i)
12. To Avert a Serious Threat to Health or Safety – 45 CFR §164.512(j)
13. Specialized Government Functions – 45 CFR §164.512(k)
14. Workers’ Compensation – 45 CFR §164.512(l)

Uses and Disclosures Requiring Written Authorization
Any use or disclosure not listed above requires your prior written authorization under 45 CFR §164.508, including:

• Marketing communications.
• Promotional use of photographs.
• Sale of PHI.

You may revoke authorization at any time in writing, except where we have already relied on it.

Your Rights Regarding PHI
Under 45 CFR §§164.520–164.528 and NYS Public Health Law §§17 & 18, you have the right
to:

• Access and obtain a copy of your medical record.
• Request corrections to your medical record.
• Receive an accounting of certain disclosures.
• Request restrictions on certain uses or disclosures.
• Request confidential communications.
• Obtain a paper copy of this Notice at any time.

Communication Risks
If you request communications via unencrypted email or text, you accept the associated risks under 45 CFR §164.522(b).

Changes to This Notice
We may change this Notice at any time under 45 CFR §164.520(b) and NYS law. Updated
versions will be posted on our website and in our office.

Complaints
If you believe your privacy rights have been violated, you may file a complaint with:
Privacy Officer – Kleydman Dermatology, PLLC, [2960 Ocean Avenue 2 nd Floor Brooklyn NY 11235] | [Phone: 718 676 6900] | [Email: kleydmandermatology@gmail.com]

Or with the U.S. Department of Health & Human Services, Office for Civil Rights.
You will not face retaliation for filing a complaint (45 CFR §160.316).

Effective Date: October 13, 2025

1. Introduction
Kleydman Dermatology, PLLC (“we,” “our,” or “us”) is committed to protecting your privacy. This Privacy Policy explains how we collect, use, and safeguard your information in compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), applicable New York State privacy laws, and best practices for website use under U.S. and international privacy frameworks.

2. Information We Collect

We may collect:

• Personal identifiers – Name, address, phone number, email, date of birth, emergency contact.
• Medical information – Medical history, medications, allergies, prior surgeries, treatment preferences.
• Payment information – Payment method details for services rendered.
  
• Clinical photographs – Taken pre- and post-procedure for medical documentation.
  
• Website usage data – Information collected automatically when you visit our site
  (cookies, IP address, browser type, pages visited, time spent on the site).
• Form submissions – Any information you provide through appointment request forms, contact forms, or email communications.

3. How We Use Your Information
Your Protected Health Information (PHI) may be used for:

• Treatment – To provide, coordinate, and manage your care.
• Payment – To process transactions for services rendered.
• Healthcare Operations – For quality improvement, compliance, and administration.
• Legal Compliance – When required by applicable law.
• Website Functionality – To improve site performance, user experience, and security.

We will not sell or share your PHI for marketing purposes without your written consent.

4. Website Data Collection and Online Privacy

Cookies & Tracking Technologies.

We use cookies, tracking pixels, and analytics tools (e.g., Google Analytics, Facebook Pixel) to:

• Improve website functionality.
  
• Analyze visitor traffic and usage patterns.
• Provide relevant advertising.

You can disable cookies in your browser settings; however, certain site features may not function properly.

 
Third-Party Services & Links.
Our website may contain links to external sites or integrate with third-party services (e.g., online scheduling platforms, financing applications, social media). We are not responsible for the privacy practices or content of these sites.

Form Submissions & Email
Information submitted through our website forms is encrypted during transmission. However, standard email is not always secure; please do not send sensitive medical information via email unless using a secure patient portal.

Do Not Track Signals
Our site does not respond to “Do Not Track” (DNT) browser settings.

Children’s Privacy
Our website is not directed to individuals under 13 years old. If you are under 13, do not submit personal information without guardian consent.

International Visitors
If you access our website from outside the United States, you acknowledge that your information will be transferred to and processed in the United States, where privacy laws may differ.

5. Patient Rights

You have the right to:

• Request and receive a copy of your medical record.
  
• Request corrections to your record.
  
• Request restrictions on certain uses or disclosures.
• Request confidential communications.
  
• Revoke communication consent at any time.

6. Communications & Risks
We may contact you via phone, text, or email for scheduling, treatment, and practice updates.

Note: Email and text are not always encrypted. By opting in, you accept this small risk. 

7. Data Security
We implement administrative, physical, and technical safeguards to protect your PHI. While we
strive to protect your data, no method of electronic transmission is 100% secure.

8. Changes to This Policy
We may update this policy at any time. The updated version will be posted on our website with
the new effective date.

9. Contact Us
Privacy Officer
Kleydman Dermatology, PLLC
2960 Ocean Avenue 2 nd Floor
Brooklyn, NY 11235
Phone: 718 676 6900
Email: kleydmandermatology@gmail.co

Effective Date: October 13, 2025

1. Financial Responsibility

• We are a self-pay practice. No h ealth insurance, Medicare, or Medicaid is accepted.
  
• Payment is due in full at the time of service via cash, major credit/debit cards, or Apple
  Pay.
  
• Cosmetic Consultation fee: $200, credited toward same-day cosmetic services or package
  purchase.
  
• Medical Visit Fees: $200, additional procedures may incur additional charges as per consultation.
  
• Packages: Must be paid in full at the first appointment, valid for one calendar year, no refunds, exchanges, or transfers.
  
• Prepaid Single Services: If not rendered, may be credited toward another service at our discretion.
• Medical Complications: If treatment is stopped early, unused portions may be credited at our discretion.
  
• Price Changes: Prices may change without notice; prepaid services honored at the original rate.